Archive for March, 2015

More and more, the level of satisfaction that patients get from their experience of a visit or stay at a hospital directly affects how successful the institution can be.

As the world of healthcare continues to go through a metamorphosis, patient feedback continues to take a bigger and bigger role in shaping the reputation of hospitals. A bad reputation will cost the hospital future patients, and even more severely, will determine how much money it is allotted from the government and from private insurers.

There are now a multitude of venues for critique and criticism that carry a great deal of weight with the public—Facebook has even been proven to be a surprisingly accurate indicator of a hospital’s approval rating, according to Health IT Outcomes. Positive Facebook reviews have a remarkably tight correlation with hospitals’ low-readmission levels, meaning that the hospitals that do not make mistakes (and thus do not require the patient to return), and are hence getting their credit on the world’s largest social media database.

In short, accurate reviews of healthcare institutions are everywhere, and are accessible to anybody. It is no wonder, then, that hospitals and clinics across the country have begun adamantly making reforms to their policies, hoping to add some compassion to their care.

Hundreds of hospitals, though, are finding it quite challenging to reel-in positive patient reviews. Kaiser Health News reported the story of Rowan Medical Center of North Carolina, which is among the lowest rated healthcare institutions in the country.

Hospitals that have a history of malpractice or poor bedside manner, such as Rowan, often find it difficult to escape their previous reputations, despite any improvements that they may have made since their previous errors. Additionally, the Medicare method of assessing hospitals from the patient’s perspective (a survey that has the patient rank the hospital on a scale of 1-10, among other examinations) is very tough, as they only reward hospitals if patients give them a 9 or a 10 on their scale. Thus, it is hard for poorly-rated hospitals to receive the funding that is necessary to training their staff or improving infrastructure.

In April, though, the government intends to kick-off a new system for ranking hospitals, which will entail a five-star scale. Officials hope that this will be easier for the consumer to understand, and will hopefully help improving hospitals avoid the stigmas of the past.

There are many ways that a hospital can improve their quality of care. According to a survey conducted by the Schwartz Center, the most successful and highly-rated hospitals in the country:

Place a high priority on their staff, so as to avoid physician and nurse burnout

Involve and interact closely with the families of patients.

Emphasize quality care and compassion when training their staff.

Have a set-in-stone schedule for their staff, so no patients are left unattended.

With luck, hospitals with poor satisfaction ratings will take advantage of the new government-implemented scale come April, and will continue to employ the aforementioned tactics in order to boost their overall patient-friendliness.

There has been much ado about the stiff penalties that come with remaining uninsured under the Affordable Care Act. Those who spent 2014 without a coverage plan are about to be slammed with either a $95 penalty or be subjected to confiscation of 1% of their income, whichever sum is higher. While Obamacare in itself is a remarkably famous piece of legislation, and nearly every American has heard of it, many speculate that the bulk of those who are still uninsured (and consequently facing penalties) are so due to simple ignorance of the mandate portion of the law.

A study by Avalere Health reveals that there is a major demographic of low-income Americans that, while being eligible for hefty government subsidies on the federal exchange, still have not purchased a healthcare plan.

An analysis by Kaiser Health News (KHN) interpreted the data, and concluded that while 76% of people with incomes between 100 and 150 percent of the official poverty level (between $11,670 and $17,505 for an individual) had enrolled for coverage last year, only 41% from the next demographic (between 151 and 200 percent of the federal poverty line) had 2014 coverage. Those individuals earn between $17,622 and $23,340, and are eligible for significant government subsidies through the federal exchange. Moreover, only 30% who rake in between $23,457 and $29,175 utilized the federal health insurance program.

Now, it is logical that those from the higher income levels do not use the federal exchange, as they can afford their own coverage or are provided some by their employers. And, while the government has done well to advertise their available subsidies and packages to the group right at the poverty line, the fact that only around 40% of those from the next-highest income levels have taken the government up on their financial aid is rather alarming, as they most likely do not have an alternative mode of attaining coverage, and will hence be hit with increasingly stiffer penalties in 2015 and 2016.

So, that begs the question—why is it that those who could benefit from the subsidies simply are not?

Caroline Pearson, senior vice president at Avalere Health, opines that it is because they still do not know about the mandate or the benefits for which they qualify. Her sentiments are felt by many who work in the world of health insurance.

Clearly, the Affordable Care act has done well to insure the poorest sector of the American populous. However, it evidently has room to grow when it comes to assisting those who, while keeping afloat above the federal poverty line, still need significant financial aid in order to practically afford coverage.

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In January 2015, the American Nurses Association revised their Code of Ethics for the first time since 2001, Nurse.com reports.

The recent revisions are the result of an 18-month process that drew from the insight of some of the United States’ most experienced nurses. The new Code of Ethics touches upon nearly all conceivable aspects of the nursing profession, from providing appropriate end-of-life care to how to handle oneself on social media.

The Code of Ethics has a long history, dating back to 1896, according to Nurse.com. Since then, the Code has evolved into a document of nine provisions and several subsequent interpretive statements that assist nurses in understanding and applying its guidelines. The new revisions process is the first in over 25 years that features revisions in both the nine provisions and the interpretive statements.

The new Code of Ethics touches upon several delicate and difficult issues that nurses face every day on the job. One of the more controversial inclusions in the new Code is a subject that deals with the issue of medically-assisted suicide and euthanasia, a topic that is hotly contested in politics and between ideological groups. Nurse.com reports that the new Code formally prevents any nurse from administering any medicine or treatment that will end the life of a patient, even if that situation comes up in the execution of death-row inmates. The guidelines make it clear that no nurse, anywhere, under any circumstance, should administer a lethal injection.

The American Nursing Association also had to tweak their documents in light of recent technological and social advances, specifically concerning social media.The new mandates that nurses pay extra close attention to not violating patient confidentiality with their personal social media accounts. Nurses who post about the condition of some of their patients on social media sites such as Twitter or Facebook violate the secrecy and privacy of patients, which the new Code of Ethics deems unacceptable.

The Code of Ethics is just one of the reasons why nursing is consistently rated at the top of the list for honest and ethical professions, Nurse.com reports. Surely, the newly revised Code will uphold the industry’s impressive reputation.

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In recent years, VA hospitals have been the subject of a great deal of controversy and scrutiny. In 2014, the Veterans’ Affairs healthcare facilities made headlines because of their inability to provide services for a large number patients, and many had to wait months before they could see doctors in what became known as the “waiting-list scandal.”

In 2015, VA hospitals have done well to cope with the influx of veterans that need appointments with doctors and surgeons. However, reports have shown that the increased quantity of patients seen has caused the average quality of care to decrease.

In a Seattle Times article, Tim Kuncl, former member of the US Coast Guard, shared his misadventures with the Puget Sound VA Health Care System.

Kuncl suffered from a rare pilon fracture in 2011 as he was putting Christmas decorations up on his home in Washington State. Three weeks later, he went to his local VA hospital and received surgery in which doctors inserted several pins, screws, and plates in order to fix his shattered bones. His pain persisted well past his expected recovery time, though, and he ended up having to get two additional surgeries done on the same leg, each one resulting in increased pain and discomfort.

Eventually, Kuncl decided to forego the VA system and get treatment from a private organization, who found that the previous surgeries had irreversibly damaged his leg, and concluded that amputation was the only path left to take. He has since become an advocate for the improvement of the VA healthcare systems.

The unfortunate case of Tim Kuncl is following a trend of increased malpractice. According to the Seattle Times, wrongful-death claims against the VA healthcare systems throughout much of 2014 climbed 43%. The Government Accountability Office has placed Vetrans Health Administration on the “high risk agency” list by virtue of its issues in oversight and training of new employees, according to the Seattle Times. The VA hospitals are treating more patients, but the number of erroneous cases has gone up rather alarmingly.

In other news, the VA healthcare system in Tomah, Wisconsin has become the subject of investigation as whistleblowers revealed that facilities have been overprescribing narcotic drugs, the StarTribune reports. In response, the VA has implemented new computer software that helps to monitor the allocation of prescription medicines. The program is called the “opioid therapy risk report,” and currently over 2,000 VA doctors nationwide now have access to the software.

With luck, the complaints against the VA healthcare systems that are piling up will reduce very soon, as the government has decided to increase its funding. The Puget Sound VA’s budget is $7.4 million larger in 2015 than it was in 2014, and will be $14.9 million larger in 2016, the Seattle Times reports. The additional funding should result in faster treatment and higher quality of care for our nation’s veterans.